| NPI | 1225512064 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 8248067-4405) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OK F07180626) |
| Enumeration Date | 2018-09-18 |
| Last Update Date | 2021-10-21 |